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Subject: High-Carb Diets and Diabetes - July09, 2005



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"Nutrition Tips"

From www.NutrActive.com
---Nutrition and Active Lifestyle Center

June 10, 2005
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In this issue:

1. Top Sponsor's Ad
2. A Word from the Editor
3. Nutrition Tip (Part 1):
---High-Carb Diets and Diabetes
4. Advertisements
5. Recommended Book:
---Eat Away Diabetes
6. Nutrition Tip (Part 2)
7. Important Links to NutrActive

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A word from the editor:

There is confusion - even among the professionals - as to what
the ratio of fats and carbs should be in the diet of someone who
has diabetes. The article below provides a nice strong argument
against increasing the fat in your diet and instead sticking with
higher carbs that are not refined. Read on for further
explanation!

Best of health!
Laura

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NUTRITION TIP (Part 1):
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HIGH-CARB DIETS AND DIABETES
by James J. Kenney, PhD, RD/LN, FACN

Back in 1988, Dr. Garg published a study and concluded that a
diet high in monounsaturated fat was preferable to one high in
carbohydrate (CHO) for people with type 2 diabetes because the
high-CHO diet raised the blood sugar levels and triglyceride
levels and lowered the HDL level compared to the higher-fat
diet.(1) I wrote a letter to the editor pointing out that this
study's results would not apply in the real world where people,
rather than researchers, determine their calorie intake. Why?
Because a higher fat diet would be expected to provide less
satiety per calorie than a diet higher in carbohydrate.

Since then many other studies have been published using the same
flawed experimental design and coming to the same largely
irrelevant conclusions. Based on these flawed studies, many now
believe diets higher in monounsaturated fats improve blood lipids
and blood sugar control in diabetics and are even better for
preventing cardiovascular diseases (CVD) than are diets higher in
CHO.(3),(4),(5)

I have written letters to the editors repeatedly explaining why
short-term studies with controlled calorie intakes lead to
conclusions that are largely irrelevant to the planning of diets
for people with CVD or diabetes. In the real world over the long
term, most people consume more calories and gain weight on diets
higher in fat and lower in CHO.(6)

Results from two long-term trials in subjects with impaired
glucose tolerance (IGT) demonstrated that a diet higher in CHO
combined with exercise led to a reduction in body weight and
about a 60% reduced risk of developing diabetes.(7),(8) No
comparable data exists to demonstrate that higher-fat diets slow
the progression of IGT to type 2 diabetes. Two studies in normal
subjects showed that the adverse changes seen in blood lipids do
not occur if the subjects, rather than the researchers, determine
how much they eat when offered either a high-fat or a high-CHO
diet.(9),(10),(11)


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material/subject matter or get-rich-quick schemes, we are not
responsible for false or non-scientific information provided by
our sponsors. If you find anything questionable, please feel
free to submit you specific question to Laura.RD@NutrActive.com.
_______________________________________________________
RECOMMENDED READING:

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Beat Type 2 Diabetes by Winning the Blood Sugar Battle
by Kristine Napier, MPH, RD, LD

This book offers a simple, straightforward program to help
people eat smart, eat well, and eat delicious meals that will
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NUTRITION TIP (Part 2):
High-Carb Diets and Diabetes
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Now a study from the University of Oregon has looked at the
impact of feeding subjects with type 2 diabetes either a high-CHO
or high-monounsaturated-fat diet ad libitum. Not surprisingly,
the adverse impacts of the higher-CHO diet on blood lipids and
blood sugar levels failed to materialize. Why? Because subjects
spontaneously ate fewer calories and lost more weight on the high-
CHO diet than on the higher-fat diet. The authors concluded, "
Contrary to expectations, the ad libitum, low-fat, high-fiber
diet promoted weight loss in patients with type 2 diabetes
without causing unfavorable alterations in plasma lipids or
glycemic control."(12)

THE BOTTOM LINE:
Losing excess body fat remains the most effective way to prevent
and treat type 2 diabetes. Diets very low in fat and high in
unrefined carbohydrate have been shown repeatedly to promote
weight loss, improve blood lipids and reduce the risk of
developing type 2 diabetes and CVD when fed ad libitum. Indeed,
only a very-low-fat diet has been shown to reverse angina pain
(13) and reverse the atherosclerotic process.(14) By contrast,
diets with more fat and less CHO will generally be more energy
dense and lower in fiber, which makes them more likely to lead to
weight gain in the long run.

Higher fat diets are less effective for preventing the
development of type 2 diabetes and CVD over the long term.
While diets high in unsaturated fats do favorably impact blood
lipids compared to high-saturated-fat diets, there remains no
evidence that diets high in unsaturated fats can reverse angina
or the atherosclerotic process. Certainly there is no evidence
a high-unsaturated-fat diet leads to reduction in ad libitum
calorie intake and promotes weight loss. Until such data are
published, a diet very low in fat and high unrefined CHO appears
preferable to one with more monounsaturated fat.

[Source Communicating Food for Health]

1. N Engl J Med 1988;319:828-34
2. N Engl J Med 1989;320:536
3. Am J Clin Nutr 1997;65:1027-33
4. J Am Diet Assoc 1997;97:151-6
5. Am J Clin Nutr 1999;69:411-8
6. Am J Clin Nutr 1999;70:423
7. N Engl J Med 2002;346:393-403
8. N Engl J Med 2001;334:1343-50
9. JAMA 1995;274:1450-5
10. Arterioscler Thromb 1994;14:1751-60
11. Arterioscler Thromb 1994;14:1751-60
12. Am J Clin Nutr 2004;80:668-73
13. J Cardiac Rehab 1983;3:183-90
14. JAMA 1998;280:2001-7
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"Nutrition Tips" is written and edited weekly by
Laura S. Garrett who is a Registered Dietitian
(R.D.) and a Licensed Dietitian (L.D.). For questions
or comments, please e-mail Jenny at:
Laura.RD@NutrActive.com.

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